Unscrambling The Current Chaos of Payer Environments: Q&A With Vera CEO, Ryan Schmid

News of General Motors partnering with Henry Ford Health System is the latest example of a big company realigning their approach toward healthcare. As more and more big companies follow suit, the current payer environment becomes more and more chaotic. To find out what’s driving this change, we sat down with Vera CEO Ryan Schmid to talk about the payer environment and a shift toward better value-based care.

Q: What is the scramble going on in the payer environment right now? How is the environment changing?

Ryan: Across the board, payers are trying to figure out how they can get closer to the delivery side. They’re also acknowledging that they have to diversify themselves beyond processing claims and negotiating price. As the market moves toward value-based contracts, everybody is recognizing that controlling primary care is a natural starting point for that.

Q:What’s driving the scramble?

Ryan: Market movement toward value-based contracting is a big part of it. Essentially, people are asking, "How do you get a better outcome for less money?" Seeing delivery systems contracting directly with employers is pretty significant, like the deal between GM with Henry Ford Health System or the decision by Amazon and Apple to bring stuff in-house. The established players, especially on the carrier-payer side see that as a threat to their core business.

Q:What are the consequences for companies? For patients?

Ryan: I think the outcome is an alignment of financial incentives which drive better outcomes for less money. That’s really the crux of the whole thing. Healthcare is so messed up today because all of the stakeholders for financial incentives are different. The shift is realigning those incentives for the people who are paying for and receiving care.

Q: How can employers overcome these new challenges?

Ryan: I think the challenge for an employer is knowing who and what to trust. There’s so much noise out there that it’s very possible for even really good things to get disregarded.

Q: How is Vera responding?

Ryan: For the last few years we’ve recognized there’s tremendous opportunity to improve our value proposition, which is already pretty strong, through partnerships with carriers. That’s why we’re very intentionally looking to work with carriers. The idea is — if we can wrap what we do around a health plan, our model is significantly enhanced. It improves our ability to exchange data, it improves coordination around case and disease management, and it improves our care transition because of better data access.

All of these things improve the value proposition to the employer. And, the fact of the matter is, by being wrapped in a product, they’re going to save money because the carrier recognizes our ability to control claims. It’s a real slam dunk.